The report summarizes findings from an evaluation of Maryland's Total Cost of Care model for its first three years (2019-2021). The evaluation found that the model reduced hospital spending by 6.6% due to reductions in acute care admissions, readmissions, and increased follow-up visits. However, non-hospital spending grew by 2.7% over the three years, with 5.5% growth in 2021. The report's findings may not reflect the current state of the model in 2022, which is estimated to miss targeted savings by $197 million.

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Insightsfrom ThreeYearsofMaryland‘sTotalCostofCare
Model
On December 20, 2022,
Mathematica published its
quantitative-only report for the
Maryland Total Cost of Care
Model’s First Three Years
(2019 – 2021).
The purpose of an evaluation is to look at
provider and patient experiences with a
model, model implementation,
transformation of the health care
marketplace around a model, and a
model’s impact on spending and quality of
care. Evaluation findings then inform
decisions related to model modification,
expansion, or termination, as well as the
design of future models.
The main driver of success in the Total Cost of Care
model is global budgets
The model reduced hospital spending by 6.6% attributed to a
reduction of all-cause acute care hospital admissions, unplanned
readmissions, and increasing timely follow up from discharge
The levers to control non-hospital spending are not yet
understood
Non-hospital spending grew by 2.7% over the three year period, but
was volatile on an annual basis with 2021 being the single largest
year of growth (5.5% growth)
This report’s findings are disconnected from the current
state of the model in CY 2022
The report states that the model reduced Medicare FFS spending by
2.5% or $781M. However, HSCRC staff estimates that the model will
miss targeted savings by $197M in CY 2022. This may lead to
questions of what occurred in 2022 to cause this swing in results.
Source: Evaluation of the Maryland Total Cost of Care Model: Quantitative Only Report for the Model’s First Three Years (2019 to 2021) Mathematica.